Table 16 Non-pharmacological treatment of medication overuse headache

The primary treatment elements:

 Abrupt discontinuation of all analgesics and acute migraine medicine or a reduction of the intake of attack medication to a maximum of 2 days per week during a 2-month period

 Training and information to patients as well as relatives and medical staff

 Psychological support, information and treatment of any withdrawal symptoms such as severe headache, nausea, vomiting, sleep disturbances, increased sweating, agitation, anxiety, nervousness, hypotension and tachycardia for 2–10 days depending on the type and amount of medicine taken

 Admission to a neurology department in cases with considerable medication overuse and/or significant comorbidity

 A sick leave of 2–3 weeks is recommended

 Follow-up with GP for 6–12 months

 Spontaneous and marked reduction of headache over weeks to months. Many patients also experience a considerable general improvement of their general condition as they are no longer affected by a daily medicine intake